Harare: The United States has said it will begin winding down health assistance to Zimbabwe after the collapse of negotiations on a proposed multi-million-dollar bilateral funding agreement.
Zimbabwe’s decision was driven by concerns over data sharing concerns, fairness, sovereignty and Washington’s broader shift away from global health institutions, government spokesperson Nick Mangwana said on Wednesday.
The US had offered USD 367 million over five years to support Zimbabwe’s priority health programmes, including HIV/AIDS treatment and prevention, tuberculosis, malaria, maternal and child health, and disease outbreak preparedness, the US embassy in Zimbabwe said.
The proposed deal would have represented the largest potential health investment in Zimbabwe by any international partner, providing “extraordinary benefits for Zimbabwean communities – especially the 1.2 million men, women, and children currently receiving HIV treatment through US-supported programmes,” US ambassador Pamela Tremont said in a statement on Tuesday.
“We will now turn to the difficult and regrettable task of winding down our health assistance in Zimbabwe,” she said, adding that Zimbabwe had indicated it was prepared to continue its HIV response independently. ” We wish them well,” said Tremont.
The US has been Zimbabwe’s largest bilateral health donor for years, providing nearly USD 2 billion in assistance since 2006, which the US says “is directly responsible” for Zimbabwe’s success in reaching United Nations targets for HIV treatment, testing and viral load suppression.
Zimbabwe has begun rolling out lenacapavir, a long-acting HIV prevention drug administered twice a year. The rollout was supported by the United States President’s Emergency Plan for AIDS Relief, or PEPFAR, in partnership with the Global Fund, raising questions about future deliveries under the programme.
Zimbabwean authorities said the funding proposal carried conditions they could not accept.
Mangwana said the US proposal was tied to “comprehensive access to Zimbabwe’s sensitive health data, including virus samples and epidemiological information from our citizens.”
He said President Emmerson Mnangagwa directed that negotiations be terminated because the US was not offering a “corresponding guarantee of access to any medical innovations – such as vaccines, diagnostics, or treatments – that might result from that shared data.”
“The United States was not offering reciprocal sharing of its own epidemiological data with our health authorities,” Mangwana added. “In essence, our nation would provide the raw materials for scientific discovery without any assurance that the end products would be accessible to our people should a future health crisis emerge.”
Zimbabwe’s College of Public Health Physicians has urged continued talks, citing the need for continued US funding for “critical components” of Zimbabwe’s public health system.
“An abrupt discontinuation of such support could risk treatment interruption, increased transmission, the emergence of drug resistance, and additional strain on the health system,” the college said in a statement.
Zimbabwe, like many low-income countries, has been grappling with the effects of aid reductions under President Donald Trump, although some programmes continued under PEPFAR. The US in January also withdrew from the World Health Organisation, part of a broader reconfiguration of global health engagement.
Under the new US framework, the Trump administration has pursued bilateral “America First” health funding agreements, replacing arrangements previously coordinated through the now-dismantled US Agency for International Development.
The US embassy in Zimbabwe said agreements worth more than USD 18 billion have been signed with 16 African countries, although recipient countries would contribute about USD 7.1 billion of this amount as part of the US drive to get countries to invest more in their own health sectors.
Several countries have already entered into the new pacts. Nigeria reached an agreement emphasising Christian-based health facilities. Rwanda and Uganda have also signed deals, while some agreements, including those with Rwanda and Cote d’Ivoire, include provisions for private US sector investment.
In Kenya, a pact signed in December has been delayed after the High Court suspended implementation pending a case filed by a consumer rights group over data safety concerns.
Zimbabwean officials criticised the bilateral model as “a departure from the multilateral frameworks” and said virus data with pandemic potential should be shared exclusively through the WHO system.
“This system is designed to ensure that when a country contributes its data, the benefits – including vaccines and treatments – are shared equitably, not commercialised exclusively by those with the resources to develop them,” Mangwana said.
